thoughts from the night shift

Welcome to the night shift. The best and worst of life as seen through the eyes of an ER Trauma nurse.

Wednesday, November 28, 2007

Out of the frying pan.....

Still not feeling 100%, but sucked it up enough to get up and go to the ICU tonight. I was all about getting my last 2 shifts over and done with, until I got there and saw that I wasn't even scheduled! FUCK! I hate that! So I decided to go downstairs to the ED to see if they had any holes. Unfortunately, they didn't. They did have a newly checked off nurse in the trauma and wanted some "experience" in there to back her up! Hell yes I can do that! (at least for 4 hours.... then I'm peacin' out and going home!)

How is it that 4 hours in the trauma room is more fun and brings more stories than weeks in the ICU?!?!?

-Had a drunk rollover..... she only had "two doubles" got to teach how to do a blood draw. This bitch was CRAZY! She had the crazy eyes and everything. I asked her several times what else she was on. She denied everything, but I'm sure her urine tox will tell the tale!

-A twenty-something guy got hit over the head with an unknown object. So he proceeds to run 22 blocks home to mommas house. When he lost feeling in his leg he waited another hour and a half to call 911. By that time he had NO feeling in his leg at all. He was waiting for an MRI.

-40 something was running around his house with eggs in a frying pan. Then his heart started beating fast. Uh huh, fast is right....240 is pretty fast! We went to do his ekg and line and he was very anxious, jumping around and asking if he could go now. Oh, and the Audrey Hepburn sunglasses that he wouldn't take off. He was very very classically paranoid schizophrenic. It took a bit to get his rate down. CCU is going to LOVE him!

So the girl I was "backing up" was leaving at 11, as was I. Our relief was waiting to give report to a chronically late nurse so I sent her on home with the promise that with my black cloud, the night was FAR from over. She laughed and took off. 5 minutes later dad runs in with a 6 year old in his arms. Poor baby was at his house when it caught fire. He was burned to both arms and his face. I took the "friend" position while the pedes staff got his IV's in and medicated him. We became buddies, even though he was obviously in a great deal of pain. I kept telling him that he was brave and that we were all so proud. He knew his name and address, his family members and their ages. When asked his phone number he replied "why, my phone is all burned up?" Touche' buddy.

When I left, firefighters were still trying to find out if the rest of his family got out of the house. There was a mom, an infant and a 2 year old still unaccounted for. My 6 year old friend was intubated and (as I promised) sleeping through the pain and having good dreams.

I still love the ER, and I will miss it. I won't miss the ICU though!

A couple of updates:

The kid whose dad was reading to him died today. His family withdrew care and donated his organs. His aunt received a kidney... and the rest went to other patients in need.

Farmer McDonald is in rehab and going home on Friday. He is walking with a walker. I'm going to visit his Thursday morning on my way home.

Monday, November 26, 2007

sick

So the day after Thanksgiving we had the "informal" new flight crew meeting. To be honest, I feel a touch over my head. The concerns that the guys with experience ask..... are way past where my thoughts are right now. They had heard of me, and knew I was a good bedside nurse, but have all acknowledged that the new folks are at the shallow end of a steep learning curve.

It didn't help that I got SICK the day after the meeting. Not food poisoning, but sore throat, earache, no energy always freezing cold, sick. The cop has gone out of his way to take care of me, and I have gone out of my way to call in sick to work! Not to mention that I still haven't had the energy to finish the paper I have due.

So as of now, I have a huge paper due, a smaller paper due, an online quiz a 3 hour charting power point for the flight job and 2 days left in the ICU. Plus, I get to pack and plan to be gone for 10 days. Ugh...

Friday, November 23, 2007

Turkey Day

I have said before, holidays in the ICU are very sad. There is the festive feeling, but with a sad undertone. Its a surreal environment. I saw one of the saddest things in my career last night. An 18 year old college freshman was on the way back from a sporting event, riding (with the rest of the freshmen) with a very elderly coach. The remainder of the team was following in the school van. The coach had some kind of medical event, went off the highway and, without hitting the brakes, hit a tree. The coach was killed on scene. The kids in the backseat had scrapes and bruises. The 18 year old in the front was flown to our hospital, unresponsive. He was in another ICU for about a week before he came to us. He has damaged the blood vessels that supply the brain and they are now a ticking time bomb.

His parents have been there every day. I think they are on the verge of withdrawing care. Last night we let dad in early. He stood by his son's bed and read Scientific American out loud. This, he said, was their Thanksgiving tradition. They would read this over dinner and discuss it. So after he read the article he started to discuss it with his son. Talk about heartbreaking.

Wednesday, November 14, 2007

OWLS

I got together with some girls last night. They have a group called OWL (Officer's Wives League). Its made up of area police officer's wives. We got together and hung out talking about girl stuff and husband stuff. Just having some wine and laughing. The serious stuff was about trying to establish this group as a fixture in the area with ALL of the departments. They provide support to the families of officers (the cop's friend's wife for example) and work to make sure that the bullshit is kept to a minimum. Currently, there is rumor of a spouse's academy in Feb and they hope to have some input as to what needs to be covered. It was really nice to see that my worries are not just mine. There is a commonality that is outside my normal (nursing) social group.

Go my financial numbers from the flight people yesterday. Its definitely a lot more than I am making now... and we work an automatic 8 hours of overtime a week. My new base manager wants to get all of the new base peeps together next week for dinner so we can all get to know each other. Our families are invited as well. I hope the cop is able to go (he works evenings next week). I still don't feel like this has all sunk in.... maybe at dinner it will, or maybe when I leave for Phoenix.

I'm in the ER tonight.... thank GOD!!!!!! So 7 more shifts in the ICU. This is WAY past any spring fever that I have ever had.

Monday, November 12, 2007

Countdown

Stick a fork in me, I'm done. It is SOOOO hard going in to the ICU. I can see the light at the end of the tunnel and its getting closer. So the motivation factor is going to be a problem over the next 3 weeks. I would LOVE to take all that PTO that I'm going to lose and just call in for a couple of days. I am still waiting for the details on salary and when I leave for Phoenix. My nurse manager in the ICU took my resignation very well and even offered to let me stay hourly. I have not seen Lurch yet, but am going to try not to rub it in.... this is going to be a hard pill for him to swallow.

My current patient had a tree fall on him and had a fracture of one of his thoracic vertebrae (think upper back, just below the neck). The problem is fixing it is that the doctors have to do a frontal and rear approach to fuse this thing. How do you get to the front of the spine when its that high up???? Why do a thorocotomy of course!

This poor guy had a (controlled) thorocotomy and then a spinal fusion. OUCH! After the blood reaccumulated he had to go back to surgery to have a VATS procedure. He is completely awake while intubated, has to lay flat the whole time and is scared shitless.

Friday, November 09, 2007

Secret

So I have been keeping a pretty big secret. (NO, NOT PREGGERS) There is a new helicopter program being started not far from my house. I applied last week and heard back on Monday, interviewed yesterday. The interview went GREAT! I told the cop afterwards that I kicked the crap outta that interview.Soo..... I got a phone call this morning and was offered the position as a flight nurse!!!!!WHOO-HOOOOO!!!!I know that it hasn't sunk in yet. I still can't even think of what to say other than thank you. The base manager told me that I gave an incredible interview and that I was exactly what they were looking for. So... I leave for critical care academy in Phoenix in 3 weeks! I emailed my nurse manager and let her know what was going on. I expected to have her all pissed off, but she was very nice and offered to let me stay hourly. I might.. will have to think about it. Am going to stay in the ER though!